| NPI | 1760573182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NH 11071) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 207022) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2007-07-09 |